Kornimate/medical-research-clean huggingface dataset:
extracorporeal elimination of cytokines following abdominal-thoracic esophagectomy

Conditions: Inflammation

Summary: this study evaluates the effect of extracorporeal removal of inflammatory mediators on the systemic inflammation reaction of patients admitted to the intensive care unit following elective esophagectomy. half of the participants will be treated with an adsorption device (cytosorbents adsorber), while the other half will be treated according to standard care. significant reductions of interleukin-6 plasma concentration, sofa score and catecholamine dosage in the intervention group are expected.

radical esophagectomy combined with extensive lymphadenectomy for esophageal cancer is one of the most invasive surgical procedures. even with progress made in surgical technique and postoperative management the rate of short- and long term complications remains high. the surgical trauma invariably causes liberation and activation of inflammatory mediators and danger associated molecular patterns, which in turn result in a pronounced systemic inflammatory reaction, leading to multiorgan dysfunction including adult respiratory distress syndrome (ards) in many patients. the subsequent counter regulation of the immune system induces immune paralysis, which is followed by infectious complications and increases the probability of severe sepsis. moreover, severe systemic inflammation causes capillary leakage, resulting in impaired wound healing and endangered anastomoses. therefore, it seems that early and effective measures against the excessive production of mediators and cytokines are indicated without impairment of the innate and adaptive immune response as it would be expected with the administration of e.g. steroids. instead, the removal of an excessive amount of circulating cytokines might be a desirable method having shown its effectivity in the therapy of septic shock in the past. the aim of this study is to demonstrate the effectiveness of extracorporeal cytokine removal to dampen the systemic inflammatory response following abdominal-thoracic esophagectomy.

Eligibility criteria:
inclusion criteria: * abdominal-thoracic esophagectomy with radical lymphadenectomy * post operative admission to icu * age \>= 18 yrs * written informed consent exclusion criteria: * participation in another interventional trial * pregnancy or lactation * systemic medication with high dose steroids and/or immunosuppressants and/or radiotherapy during the last 3 months * known diseases of the immune system (benign and malign) * contraindications for extracorporeal therapy * thrombocytopenia \< 50\*10\^9/l * therapy limitations (dnr), moribund status * missing informed consent

Keywords: esophagectomy inflammation hemoperfusion cytokines
post-operative results of the trapezometacarpal (tmc) prosthesis for advanced pre-operative deformities

Conditions: Rhizarthrosis; Arthritis

Summary: trapezometacarpal protheses are implanted for patients with trapezometacarpal arthritis. having a pre-operative thumb adduction angle of less than 25 degrees with hyperextension, meaning a " z-deformity " are somehow a reason to go for another surgical treatment: trapezectomy with ligament reconstruction. this study will aim at analyzing the results of another surgical treatment which is the trapezometacarpal arthroplasty in this type of deformities.


Eligibility criteria:
inclusion criteria: * patient with tmc joint arthritis * patient with adduction \<25 degrees * patients with z deformity * patient operated for tmc joint arthroplasty exclusion criteria: - tmc arthroplasty implanted for fractures

Keywords: trapezometacarpal joint arthritis adduction angle <25 degrees decrease of the grasping and pinching forces z deformity of the thumb
pilot study of nkg2d car-t in treating patients with recurrent glioblastoma

Conditions: Recurrent Glioblastoma

Summary: this is a pilot phase i study to evaluate the safety and efficacy of nkg2d car-t cell therapy in patients with relapsed and/or refractory glioblastoma


Eligibility criteria:
inclusion criteria: * histologically confirmed glioblastoma multiforme (gbm) and are at first or second relapse. * hemoglobin ≥ 9.0 g/dl, absolute neutrophil count (anc) ≥ 1,000 cells/µl, platelets ≥ 125,000 cells/µl * no active infection of hiv, htlv and syphilis * adequate renal function * adequate hepatic function * adequate cardiac function * adequate venous access for apheresis, and no other contraindications for leukapheresis * voluntary informed consent is given. exclusion criteria: * pregnant or lactating women. * uncontrolled active infection. * history of hepatitis b or hepatitis c infection. * previously treatment with any gene therapy products or cell therapy product in past 28 days. * cannot undergo mri with contrast or spect/ct * hiv infection. * have autoimmune disorders * have active infection or inflammatory disorders * prescreening test results in expansion rate less than 5 folds * an allergy to gentamycin and/or streptomycin
endoscopic treatment of bronchial carcinoid tumors

Conditions: Carcinoid Tumor

Summary: carcinoid tumors of the lung are considered to be a low-grade malignancy. surgical resection is considered the standard approach. recent data has shown that a complete endoscopic treatment could be considered. an endoscopic treatment is can be a alternative to invasive surgery.

the objective of this study is to evaluate the feasibility and therapeutic method of endoscopic treatment of bronchial carcinoid tumors.

Eligibility criteria:
inclusion criteria: * patients treated by endoscopic approach for a carcinoid tumor at the university hospital centre of saint-etienne between november 1995 to december 2017. exclusion criteria: * patients treated for a recurrence of carcinoid tumor. * patients with metastatic disease.

Keywords: carcinoid tumors endoscopic treatment recurrence
a study of apatinib versus docetaxol patients with advanced gastric cancer

Conditions: Gastric Carcinoma

Summary: this multicenter, randomized study will evaluate the efficacy and safety of apatinib compared to docetaxel treatment in patients with advanced gastric cancer. at the start of the trial, patients will be randomized to one treatment arm: arm a: apatinib 850mg qd every 3 weeks; arm b: docetaxel 60mg/m2 every 3 weeks. tumor assessment will be done every 8 weeks according to recist 1.1. the primary endpoint is progression free survival (pfs).


Eligibility criteria:
inclusion criteria: * adult patients, aged ≥18 years; * histologically confirmed advanced or metastatic adenocarcinoma of gastric cancer(agc) , including adenocarcinoma of the gastroesophageal junction ; * at least one measurable and evaluable disease based on response evaluation criteria in solid tumors (recist v1.1); * patients must have received one prior chemotherapy regimen for agc;first-line therapy must have included a combination of at least a platinum-based treatment given concurrently, and must have experienced disease progression during or after first-line therapy for their disease; * eastern cooperative oncology group(ecog) performance status of 0 or 1; * life expectancy of more than 3 months; * duration from the last therapy is more than 6 weeks for nitroso or mitomycin, more than 4 weeks for other cytotoxic agents, operation or radiotherapy; * adequate hepatic, renal, heart, and hematologic functions ( hemoglobin≥ 90g/l, platelets ≥ 80 × 109/l, neutrophil ≥1.5 × 109/l, serum creatinine≤ 1.5mg/dl, total bilirubin ≤1.5 ×uln, and serum transaminase≤2.5×uln); exclusion criteria: * pregnant or lactating women; * history of other malignancies except cured basal cell carcinoma of skin and carcinoma insitu of uterine cervix; * prior chemotherapy regimen have included taxane (docetaxel or paclitaxel); uncontrolled hypertension; * intercurrence with one of the following: coronary artery disease, arrhythmia and heart failure; * urine protein\>grade 1; * any factors that influence the usage of oral administration; * patients with a clear tendency of gastrointestinal bleeding; * abnormal coagulation function(inr≥1.5, aptt≥1.5 uln); * abuse of alcohol or drugs; * less than 4 weeks from the last clinical trial; * prior treatment with antivascular endothelial growth factor or the other anti angiogenesis therapy; * evidence of central nervous system(cns) metastasis; * disability of serious uncontrolled intercurrence infection.

Keywords: gastric carcinoma apatinib
effect of hfno therapy on respiratory effort after extubation

Conditions: Respiratory Failure; Post Extubation Acute Respiratory Failure Requiring Reintubation

Summary: rationale: despite the lack of clear clinical protocols, high flow nasal oxygen (hfno) is used as post-extubation respiratory support. although hfno seems to reduce the need for re-intubation, scepticism on its use persists as the mechanism of action in post-extubation patients remains undefined. monitoring weaning from invasive mechanical ventilation while monitoring respiratory effort might help to determine the added value of hfno surrounding extubation. we hypothesize that hfno, compared to conventional oxygen therapy (cot), prevents de-recruitment of the lung and reduces respiratory effort, and so provides a physiologic clarification for the reduction in the need for reintubation. objective: determine the physiological effect of hfno compared to cot in the extubation phase regarding respiratory effort and lung aeration. study design: a physiologic, randomized clinical study comparing two standard of clinical care therapies. study population: adult patients on invasive mechanical ventilation (imv) for \>72 hours, who are scheduled for extubation. intervention (if applicable): before extubation, patients are randomized to receive cot (reference group) or hfno as oxygenation regimen after extubation. main study parameters/endpoints: the main outcome is the difference in change in lung respiratory muscle effort (mean δpes) at 24 hours post-extubation between the study groups. secondary parameters are differences in changes in respiratory effort at 2 and 4 hours post-extubation, difference in change in lung aeration (mean δeeli), differences in tidal volume, dyspnea score, and respiratory and sputum parameters between patients undergoing different post-extubation oxygenation regimens.


Eligibility criteria:
inclusion criteria: * aged ≥ 18 years * receiving imv \> 48 hours for any cause * successfully completing spontaneous breathing trial (sbt) as per local clinical guideline * provided written informed consent, through legal representatives on indication exclusion criteria: * any clinical situation preventing appropriate execution of study procedures * the presence of a tracheostomy * any feature that precludes hfno-initiation * indication for niv such as hypercapnia at end of sbt, or obstructive/central sleep apnoea syndrome or obesity hypoventilation syndrome with cpap use in medical history * contra-indication for nasogastric tube or inability to perform adequate pes measurements. * known diaphragm paralysis defined as elevated hemi-diaphragm on x-ray and evidence of paralysis during ultrasound (i.e. paradoxal diaphragm movement during sniffing) * known pregnancy or current breast-feeding

Keywords: high-flow oxygen intensive care unit extubation reintubation respiratory effort aeration
gw501516 in subjects who have low level of high-density lipoprotein cholesterol

Conditions: Dyslipidaemias; Dyslipidaemia

Summary: the purpose of this clinical research study is to compare up to 3 doses of an investigational drug gw501516 to placebo (an inactive pill that looks like gw501516) to see if it is safe, well tolerated and effective in improving (raising) low levels of "good cholesterol", high-density lipoprotein cholesterol (hdlc), as compared to placebo.

a multicentre, two-staged with interim analysis, parallel, randomised, double blind, placebo-controlled, dose-ranging study of the safety, tolerability, and effects on plasma high-density lipoprotein cholesterol (hdlc) of 12 weeks treatment with 2.5mg, 5mg and 10mg daily doses of gw501516 in subjects with low hdlc

Eligibility criteria:
inclusion criteria: * have a fasting plasma hdlc concentration \<=45mg/dl (\<=1.16mmol/l), plasma ldlc levels that do not require treatment according to the national cholesterol education program/adult treatment panel iii (ncep/atpâ iii) guidelines. * have a fasting plasma tg concentration =500mg/dl (=5.65mmol/l). exclusion criteria: * coronary heart disease. * diabetes mellitus. * atherosclerotic disease.

Keywords: hdlc high-density lipoprotein dyslipidemia
ktp green light prostatectomy compared with open prostatectomy

Conditions: BPH (Benign Prostatic Hyperplasia)

Summary: the purpose of this study is to compare safety and efficacy of green light pvp (photoselective vaporisation of the prostate) compared to open prostatectomy when treating benign prostatic hyperplasia (bph).


Eligibility criteria:
inclusion criteria: * men undergoing surgery for bph with prostate size more than 100cc exclusion criteria: * previous prostate surgery * carcinoma of the prostate * neurogenic bladder * bladder carcinoma
perioperative use of gabapentin to decrease narcotic requirements in spinal fusion

Conditions: Postoperative Pain

Summary: blinded study using oral gabapentin in load pre-operative (15mg/kg) and maintenance 5mg/kg three times a day (tid) for 5 days or discharge, patient controlled analgesia (pca) morphine and placebo group with similar pills, also pca morphine. the goal is to measure morphine usage and incidence of morphine side effects (pruritis, days foley, days to first stool, sedation, pain scores, pca use).

healthy, american society of anesthesia (asa) 1-2 idiopathic scoliosis patients for spinal fusion. blinded, drug only known by hospital pharmacist. study group 1- gabapentin 15mg/kg with premed, 5/kg tid for 5 days of discharge, standard pca morphine with dose and basal study group 2- capsules resembling neurontin, with standard pca morphine no remifentanil, clonidine, ketamine n=60 first patient enrolled 6/06 last patient enrolled 7/15/08

Eligibility criteria:
inclusion criteria: * asa 1-2, idiopathic scoliosis exclusion criteria: * asa 3 or greater * neuromuscular scoliosis * on narcotics baseline

Keywords: gabapentin pediatric spinal fusion narcotic use
impact of help-seeking behaviors on allergic rhinitis and mental health: a longitudinal study

Conditions: Mental Health Conditions; Allergic

Summary: this study explores how help-seeking behaviors for both emotional well-being and allergies impact the management of allergic rhinitis, asthma, and mental health symptoms, including anxiety and depression. the research involves a retrospective and longitudinal analysis of patients who sought treatment for allergic rhinitis and mental health concerns. the goal is to highlight the importance of integrating mental health care into allergy treatment plans to improve overall patient outcomes.

this study aims to investigate the impact of help-seeking behaviors (hsb) on allergic rhinitis (ar), asthma control, and mental health outcomes, such as anxiety and depression, using both retrospective and longitudinal data. the study examines patients who have been diagnosed with ar and mental health conditions to assess how seeking professional help for allergies, emotional well-being, or both influences symptom control and quality of life. the research analyzes data from a diverse patient population to evaluate the effects of ar medications (intranasal steroids, antihistamines, decongestants, and leukotriene blockers) on both ar and mental health symptoms. additionally, it explores the role of help-seeking behaviors in improving symptom management, specifically through the use of validated tools like the snot-22 for ar and the phq-gad16 for mental health. the study emphasizes the importance of integrating mental health screening and support into the treatment of allergic rhinitis and asthma. by analyzing real-world data, the research seeks to provide insights into how coordinated care approaches can enhance patient outcomes and inform future clinical practices.

Eligibility criteria:
inclusion criteria: adults (aged 18 years or older) patients actively receiving care in a primary care setting. patients who have provided informed consent for their health data to be included in the research repository. exclusion criteria: patients who have not provided informed consent for their health data to be included in the research repository. patients diagnosed with chronic conditions outside the scope of allergic rhinitis, asthma, or mental health conditions (anxiety, depression). patients with severe mental health disorders or comorbidities that are unrelated to the conditions of interest (e.g., schizophrenia, bipolar disorder, etc.).

Keywords: allergic rhinitis asthma control mental health help-seeking behaviors integrated care
prophylactic pulmonary vein isolation study

Conditions: Atrial Fibrillation

Summary: this study is being done to learn the effects of the pulmonary vein isolation in patients that are at high risk to developing, but do not have a documented history of atrial fibrillation.

patients with a dilated left atrium (left upper chamber of the heart) that undergo mitral valve surgery may be at risk for the development of atrial fibrillation after surgery. atrial fibrillation (also known as "a-fib" or af) is an abnormal heart rhythm which may cause symptoms such as pounding sensations in your chest, dizziness, fatigue, chest pain and/or shortness of breath. af patients are at a higher risk of developing a stroke. participants who sign informed consent will be randomized into one of two groups by chance (as in the flip of a coin). approximately 77 patients will undergo their mitral valve operation along with pulmonary vein isolation (a treatment group) and 77 patients who do not undergo pulmonary vein isolation at the time of their mitral valve surgery (a control group). the treatment group will undergo operation for mitral valve disease with an additional procedure called pulmonary vein isolation using a device that delivers radiofrequency energy to the heart muscle in order to create scar tissue to block electrical impulses that can trigger episodes of af. the control group of patients will undergo operation for mitral valve disease without the additional pulmonary vein isolation.

Eligibility criteria:
inclusion criteria: * indication for open-heart surgery: mitral valve repair or replacement, evidence of a dilated left atrium exclusion criteria: * history of atrial fibrillation * need for emergent cardiac surgery * previous cardiac surgery * preoperative need for an intraaortic balloon pump or intravenous inotropes * current diagnosis of active endocarditis * mental impairment/or experience other conditions which may not allow subject to understand nature * significance and scope of study * pregnancy

Keywords: atrial fibrillation af a fib cardiac ablation modified maze procedure
management of bleeding and coagulopathy in trauma and compliance to european trauma guidelines

Conditions: Wounds and Injury; Bleeding

Summary: this cohort study describes the epidemiology of trauma patients and their management in a french academic trauma center. it also aims to determine what recommendations from the european trauma guidelines is applied in routine.

severe trauma is responsible for more than 5 millions of deaths annually worldwide. haemorrhagic shock secondary to uncontrolled bleeding is the leading cause of preventable death in this population, making bleeding and coagulopathy treatment a key element of the early phase of trauma management. european trauma guidelines have been developed to help clinicians in severe trauma management and improve bleeding and coagulopathy treatment in this population. investigating who these guidelines are followed in routine is crucial to identify opportunities to improve early management of bleeding severe trauma patients.

Eligibility criteria:
inclusion criteria: * trauma patients with injury severity score equal to or higher than 16 year old admitted to the brest academic trauma centre within the 24 hours following the trauma exclusion criteria:

Keywords: trauma bleeding coagulopathy guidelines compliance recommendation transfusion
study assessing an insulin pump-controlling algorithm to minimize hypo and hyper in type 1 during crc setting

Conditions: Type 1 Diabetes Mellitus

Summary: feasibility study assessing the ability of an insulin pump-controlling algorithm to minimize hypoglycemia and hyperglycemia in patients with type 1 diabetes in a clinical research setting.

this study is a non-randomized, uncontrolled feasibility study that looks to enroll people with type 1 diabetes who are currently using an insulin pump. during the subject's participation, the study staff will closely monitor the study subject in a clinical research center environment for approximately 30 hours, while controller algorithm determined insulin doses are delivered by an insulin pump, and utilizing continuous glucose monitoring results.

Eligibility criteria:
inclusion criteria: * age 21-65 years * type 1 diabetes mellitus for at least one year * currently using an insulin infusion pump for at least the past 6 months exclusion criteria: * pregnancy * history of diabetic ketoacidosis (dka) in the past six months * histoey of severe hypoglycemia (seizure, unconsciousnesss) in the past 6 months

Keywords: type 1 diabetes mellitus artificial pancreas
acceptability of identifying and managing psychological distress in inflammatory bowel disease: the compass-ibd study

Conditions: IBD; Psychological Distress; Treatment of Illness-related Distress in IBD

Summary: this study is a single-centre, interventional implementation and feasibility study. patients in the ibd service will be able to access compass, an online cognitive-behavioural therapy (cbt) programme, as part of standard care at guy's and st thomas's nhs foundation trust. compass is an online program. it will consist of 11 online modules which target challenges associated with living with ibd (and other long-term conditions) and includes, amongst other things, psycho-education, patient examples, interactive tasks and goal setting. participants are linked to a therapist; 'guide', who will provide 5-6 x 30 minute support sessions delivered fortnightly in the format preferred by the client (phone and/or in-site message).


Eligibility criteria:
patient participants inclusion criteria: 1. aged 18 or over 2. have an ibd diagnosis 3. have english proficiency 4. have access to a computer 5. have mild to moderate symptoms of depression and/or anxiety (phq-9 score 5-19 and/or gad-7 score 5-14, or phq-ads score 10-29) or severe depression and/or anxiety (phq-9 score≥20 and/or gad-7 score ≥15, or phq-ads score ≥30 but no acute suicidal risk) and awaiting treatment from clinical psychologist as specified above. 6. have evidence of illness-related distress exclusion criteria: 1. evidence of substance dependency, cognitive impairment, severe mental health conditions 2. evidence of acute suicidal risk phq-9 item-9 \>1 and recent serious suicidal intent and/or planning 3. are receiving current psychological treatment or are on a wait-list to receive treatment within the study period (next 6 months) 4. have depression and/or anxiety unrelated to ibd (e.g. where disease long-standing/well-controlled unrelated to current presentation of distress) healthcare professional participants 1. work in the gastroenterology ibd service at guy's and st thomas' hospitals nhs trust (gstt). 2. have experience of either: i) utilising the routine mental health screening tools ii) assessing and triaging patients onto the compass programme and/or iii) providing therapist support to the users of compass.